The influence of insulin therapy on measurements of optical coherence tomography parameters in diabetic patients without retinopathy

AbstractPurposeTo determine whether there was a change in the fundus of the eye in diabetic patients without retinopathy after insulin therapy.MethodsThe diabetic patients without retinopathy were included in this study. A swept-source optical coherence tomography/angiography (SS-OCT/A) was used to obtain the measurements of macular retinal nerve fibre layer (mRNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, retinal thickness (RT), macular choroidal thickness (MCT), peripapillary retinal nerve fibre layer (pRNFL) thickness, peripapillary choroidal thickness (PCT), and perfused vascular density (PVD). Univariable and multivariable regression analyses were performed to explore the influence of insulin use on measurements of OCT/A.ResultsA total of 1140 patients used insulin (using group), and 126 patients did not use insulin (without group). The average MCT of the using group was 171.3±67.8 μm, which was thinner than that in the without group (190.2±74.7 μm) (P=0.012). The average PVD of the using group (48.0±2.1 μm) was less than that in the without group (48.7±2.1 μm) (P<0.001). After adjusting for age, gender, axial length, duration, HbA1c, systolic blood pressure, diastolic blood pressure, cholesterol, serum creatinine, insulin use was significantly associated with thinner MCT (beta=-16.12μm; 95%CI:-29.42, −2.81μm; P= 0.018) and lower PVD (beta=-0.79; 95%CI: −1.22, −0.36; P<0.001).ConclusionThe use of insulin by diabetic patients without retinopathy might decrease the MCT and PVD compared to patients who did not use insulin, which helps to better understanding the role of insulin use on higher risk for diabetic retinopathy.

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Retinal nerve fibre layer thickness measurements in childhood glaucoma: the role of scanning laser polarimetry and optical coherence tomography

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05276-z ◽

2021 ◽

Author(s):

Mael Lever ◽

Christian Halfwassen ◽

Jan Darius Unterlauft ◽

Nikolaos E. Bechrakis ◽

Anke Manthey ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Nerve Fibre ◽

Retinal Nerve Fibre Layer ◽

Scanning Laser ◽

Optical Coherence ◽

Scanning Laser Polarimetry ◽

Laser Polarimetry ◽

Nerve Fibre Layer ◽

Thickness Measurements ◽

Inferior Quadrant

Abstract Purpose A central diagnostic tool in adult glaucoma is the peripapillary retinal nerve fibre layer (pRNFL) thickness. It can be assessed by scanning laser polarimetry (SLP) or optical coherence tomography (OCT). However, studies investigating the relevance of pRNFL measurements in children are rare. This study aims to compare the glaucoma diagnosing ability of SLP and OCT pRNFL thickness measurements in a paediatric population. Methods This retrospective study included 105 children (glaucoma: 22 (21.0%); healthy glaucoma suspects: 83 (79.0%)) aged 4–18 years, examined with SLP (GDxPro/ECC, Carl Zeiss Meditec) and spectral-domain OCT (SPECTRALIS®, Heidelberg Engineering). The thickness of pRNFL sectors was compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC) and logistic regression results were used to compare the glaucoma discriminative capacity between SLP and OCT measurements. Results Using OCT, pRNFL thickness was decreased in the superior, nasal, and inferior quadrants of glaucoma patients compared to healthy controls (P < 0.001, each). With SLP, such a difference was only observed in the inferior quadrant (P = 0.011). A correlation between glaucoma diagnosis and OCT-measured pRNFL thickness was found in all quadrants (P < 0.001) other than the temporal. With SLP, a correlation was found for the total average thickness (P = 0.037) and inferior quadrant (P = 0.0019). Finally, the AUCs of OCT measurements were markedly higher than those of SLP (e.g., inferior quadrant: OCT 0.83, SLP 0.68). Conclusion pRNFL thickness measurements using both OCT and SLP, correlate notably with the presence of glaucoma. In general, the diagnostic performance of pRNFL thickness measurements seems higher for OCT than for SLP. Thus, pRNFL thickness measurements could provide important information, complementing conventional clinical and functional parameters in the diagnostic process of paediatric glaucoma.

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